New Respiratory Rapid Access Service reduces ED presentations and hospital admissions.

<bold>Aim:</bold> Increased demand for inpatient and Emergency Department (ED) healthcare, hospital congestion, and increased urgent referrals requires adaptive healthcare practises. We designed and implemented a Respiratory Rapid Access Service (RRAS) offering respiratory patients a safe, alternative urgent pathway. <bold>Methods:</bold> RRAS was implemented as a part-time pilot service. Approved pathways included direct patient contact, specialty or ED referral and expedited urgent referral review, including symptomatic malignancy. Respiratory physician review occurred within 24-72hrs in a specialist clinic. Data captured included patient demographics, medical activity, ED presentations avoided, hospital admissions prevented and qualitative patient evaluation. <bold>Results:</bold> In 10-months 393 patients were reviewed: 681 separate episodes of care. Commonest respiratory pathology was malignancy, pleural, and airways disease. RRAS prevented 359 ED presentations, saving 2129 ED hours. 181 hospital admissions avoided, and 115 early discharges facilitated, equating to 957 bed days saved. 300 urgent referrals, 115 interventional procedures and 77 MDM discussions expedited.100% patients who used RRAS deemed it an appropriate alternative to ED and 100% felt comfortable using RRAS again. <bold>Conclusion:</bold> The RRAS pilot successfully demonstrated prevention of ambulance calls, ED presentations, and hospital admissions with reduced inpatient separations and average length of stay. Expedited reviews optimised delivery of urgent care, and reduced cancer time to diagnosis via streamlined diagnostics. We will expand to full-time, offering increased urgent respiratory medical and nursing reviews, ultimately streamlining future healthcare delivery.